Aim:Hydrocephalus is a condition characterized by the excessive accumulation of cerebrospinal fluid in the brain’s ventricular system, leading to ventricular enlargement and increased intracranial pressure. This study aimed to evaluate whether transfontanel ultrasonography could serve as a practical and less complex alternative to brain magnetic resonance imaging in infants with hydrocephalus. Material and Methods:In this prospective study, 54 infants diagnosed with hydrocephalus underwent both transfontanel ultrasonography and brain magnetic resonance imaging. A neonatologist and a radiologist independently assessed ventricular measurements, including the Evans index, frontooccipital horn ratio, bilateral ventricular index, anterior horn width, thalamooccipital distance, callosal angle, and corpus callosum length.Results:Among the 54 infants, 48 (88.9%) received a ventriculoperitoneal shunt. A strong correlation was found between transfontanel ultrasonography and magnetic resonance imaging for most ventricular measurements: Evans index (r = 0.875, p = 0.0001), frontooccipital horn ratio (r = 0.867, p = 0.0001), callosal angle (r = 0.868, p = 0.0001), bilateral ventricular index (left r = 0.937, right r = 0.944; p = 0.0001 for both), bilateral anterior horn width (left r = 0.918, right r = 0.908; p = 0.0001 for both), and bilateral thalamooccipital distance (left r = 0.956, right r = 0.919; p = 0.0001 for both). The correlation for corpus callosum length was statistically significant but weaker (r = 0.386, p = 0.004).Conclusion:Our study emphasizes that transfontanel ultrasonography—which achieves better results in experienced hands—should be widespread and an excellent alternative to unnecessary and repeated imaging methods.